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Process for labeling antigen typed units


bbbirder

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I am looking for ideas on how to change our process for labeling antigen typed units after we have completed testing.

Do you have a 2nd label check for this? (How do you do this check? same tech, different tech, how do you document?)

Use manual logsfor recording antigen typing results?

Enter results into your computer system? If so, print out anything from this system for use while labeling?

I am just looking for a way to help prevent errors. (Especially when you are antigen typing many units for multiple antigens for multiple patients.)

Thanks,

Linda Frederick

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Heaven help u Linda, because this may confuse u more than help!

Donor Center:

We enter our testing results (Second testing and first, two techs) into donor antigen history page. Entry is checked by second tech.

We print: product page (which has unit and donor number on it) and the member antigen page (which has member number and all Ag testing).

When we label: 2 techs have the 2 printouts, the antigen label/tag and the actual unit. The numbers are all crosschecked to match the right ag.s to the right label to the right unit. Confused yet?

It's much easier than it sounds, but I hate it for the poor trees. We both initial the ag. label/tag and the 2 printouts that are stapled together documenting that we hopefully have married the right info to the right unit.

We keep the printouts for about 3 months just for our records in case there is a discrepancy anywhere. This has evolved over about a 15 year period of oops how can we keep that from happening again. Elaborate and maybe overkill.............but we have not had a mislabeled ag unit go out in a very long time ( so far as we know). The only exception is if we are screening for something easy (just BE) and we just label off of the testing sheet where we just tested one behind the other.

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Transfusion Service:

We use a computer system and a separate sticker placed on the individual unit. There is no second tech, usually 1 tech does all the testing. The units are scanned into the computer and the appropriate testing is filed. Then, a separate sticker is placed on the unit. It has the ~20 of the most common antigens with a space next to each and we place either a "0" for negative or the graded reaction result (ie w+ to 4+).

Our load is not astronomical, we usually need 2-4 units for a patient with an antibody, but there have been times where a trauma/OR patient needed much more (I think one time an antibody pt needed >80 PRBC's. This is not the norm, though. And for our patients requiring rare units, we request them from our Blood Center.

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Do you purchase these labels from Shamrock or Veriad?

We are a transfusion service, and it seems like the antibodies come in waves. Lately we have multiple patients with both Fy's and Jk's, (various combinations of -a and -B), as well as the usual assortment of Rh's and K's.

Thanks for your ideas, and keep them coming!

Linda Frederick

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We document our antigen typing result on worksheet and enter them in computer. All negative antigen typing of the units gets confirmation done by second tech. Same process--second tech documents on worksheet and enter them in the computer. we have segregated area for antigen negative units.

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I buy small manilla tie tags. The tech tests the units when indicated; the tie tag is stamped with our blood bank identification on one side. One of the unit bar code labels is placed on the other side along with the antigen typing, date and tech. This is then tied to the bag. The unit testing and control results are recorded in a manual paper log (but will soon be a part of a computerized testing record).

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  • 2 weeks later...

We used to scan units into the computer for testing, but since we switched to Meditech, we don't do it this way. As you know Meditech isn't user-friendly for antigen typing.

We have a paper log. We put a barcode unit sticker on the log. I made a laminated template to go over the log with see-through and/or open spaces for the current line to keep our eyes on the right line. We can then scan the unit number right through the template into Unit Edit to add the ag typing. Then we mark through the template onto the log to document that we have entered that one and move down to the next line.

It is not foolproof. We could put the wrong sticker on the log initially or crossmatch the wrong unit. In the latter case, Meditech should flag that the unit isn't antigen typed so the tech should know to double-check. The only problem is that Meditech is known for tossing up messages when you don't expect them so the techs don't always trust it to be right.

I would be interested in any solutions for places that only have one tech and an MLT on at night & almost never more than one tech in BB. Rechecks by second techs are pretty tough in that circumstance. Sometimes they assume that the original must be right and don't check very hard or the first person assumes that the second will catch any mistakes. I think a good deal of fear about antigen typing is a healthy thing.

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  • 4 weeks later...

Meditech isn't user-friendly for antigen typing.

We are Meditech C/S and have worksheets for antigen typing which include the Pos and Neg controls. First we order an antigen "group" test on each unit. The "group" includes the "T" tests for reaction, check cell and result. We create the worksheet that calls all antigen testing on to it. We record the reactions in the computor and verify the worksheet which edits the units accordingly. Custom labels are then printed that include the unit#, unit ABORH, date, and the antigen-POS/NEG.
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Do you purchase these labels from Shamrock or Veriad?

We use Veriad (United Ad Label) part # ULBX736

Unit Negative when tested for __________ Antigen.

Date _________ Tech _________

We use Sunquest LIS, so antigen testing results on the patient go into the same field with antibody results. These results are displayed anytime you crossmatch the patient.

The antigen testing on units also go into the computer in 2 different ways, depending on whether done at Ref Lab (entered in BPE - Blood Product Entry), or done in house, results are entered with crossmatch by adding test AO (antigen other). Both ways will send the results to the unit's permanent file.

We have a paper form for recording results (lot numbers, controls, etc).

If you would like a copy of our form, send me a PM with your email and I'll send you a copy.

Gil

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Custom labels are then printed that include the unit#, unit ABORH, date, and the antigen-POS/NEG.

Is this "custom label" from generated from Meditech? I tried setting something like this up in Meditech, but was not pleased with the format.

(Also, I didn't like that I couldn't print them from the "process unit routine".)

Linda F

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  • 2 years later...
  • 2 weeks later...

we use the labels from Veriad and document on the sticker the testing result. The label is placed on the unit by person who tested for the antigen and the results are also recorded in our LIS software. This includes only antigen-negative blood that is documented in the LIS, all antigen results are recorded on our daily testing log and are reviewed by myself or my counterpart for accuracy and completeness. I have a question regarding process, if you do not use the blood that has been tested do you remove the label when issuing for a patient with no antibody? There are always inquisitive nurses that question the presence of the antigen label, normally I do no remove them upon reissue.

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We leave antigen labels on the unit once they are labeled. I usually explain to the nurse the fact that the ID of the antigen status was for another patient and should not have any effect on the patient they are about to transfuse. This is usually enough information to set their mind at ease.

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We also place the hot pink Veriad stickers on all the donor units that have been antigen-typed, both antigen-positive and antigen-negative units. All antigen testing is recorded in the Blood Bank computer at the time the testing is done.

If we are issuing the donor unit to a patient who doesn't have unexpected antibodies, it doesn't matter to us whether the pink sticker stays on the unit or is removed. (As Deny stated above, if a nurse calls & questions the sticker we explain it was tested for another patient who no longer needs the unit.)

Donna

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